*My Turnitin score is too high. I need assistance on properly paraphrase and add citations.Nurse to Patient Ratios

Question *My Turnitin score is too high. I need assistance on properly paraphrase and add citations.Nurse to Patient RatiosA huge factor in providing safe and effective care is patio ratios and adequate staffing. We can’t control the influx of patients. With patients at inpatient hospitals or other care facilities, their length of stays can vary for a number of reasons. Even with continuous change, nurses continue to have more patients to care for, and almost always understaffed. This results in having less time to complete patient cares, assessments, medication administration, and unforeseen problems such as falling or coding. With the added patient load, understaffing, and less time to care for our patients, we put our licenses at risk as well as patient safety and care (Glette et al., 2017). Nursing Practice IssueIt isn’t just the issue of understaffing that factors into the issue of patient safety, nurses can also get burned out quick. Poor wellbeing and moderate to high levels of being burned out are directly associated with poor patient safety and medical errors (Hall et al., 2016). Nurse understaffing negatively effects patient safety, and the patient’s wellbeing, health, and their outcome of their stay suffer. Patients who are admitted to the ICU or ER departments are at greater risk of any event regardless of staffing. But these patients are more vulnerable to being checked up on, medication errors, and lack of basic cares. RN’s and LPN’s are huge contributors to basic care given in the healthcare facility they work in. Some basic care examples are wound cleaning, skin assessments, patient specific assessments, and periodic surveillance of the patient. With understaffing, sometimes these basic cares go unfulfilled, or fulfilled extremely late. Characteristics and factors of understaffing can be linked to the type of hospital, ward, and characteristics of patients (Driscoll et al., 2017).RationalePoor nurse-to-patient ratio results in the delivery of inadequate health care services, low patient satisfaction and burnout among nurses; the burnout may lead to an increased turnover rate and therefore nursing shortages. In the study conducted by Hall et al. (2016), it was found that various negative feelings in the workplace, such as depression, anxiety, stress, and low wellbeing were associated with poorer patient safety outcomes and a higher incidence of “near misses.” The study also concluded that healthcare professionals were at higher risk for errors when they were experiencing both poor well-being and burnout, compared to experiencing only one of these at a time. A balanced nurse-to-patient ratio promotes positive outcomes in healthcare settings. Nurses, patients, and healthcare facilities usually record more success when a safe nurse staffing method is utilized.Appraisal of ResourcesLiterature reviews are extremely important, as they help us gather accurate information on the topic we are researching. It can build rapport with the reader, especially on topics that you are no expert in. We can avoid incidental plagiarism by citing our sources in our publication. I chose my articles by searching key words such as “burned out nurses”, “nurse to patient ratio problems”, and “understaffing and patient error”. I used a wide variety of databases and made sure that they were all peer reviewed. I use google scholar a lot, because I am most familiar with that data base and it gives me a wide range of different results. I limited my search to anything that was less than 5 years old. I thought this was the best way to give accurate information since every year differs, especially in my topic. I get a lot of my information for NCBI because it is a free data base that makes sure the authors are credible. These sources add value to my paper my providing me with information and studies related to my topic, nurse to patient ratios & understaffing. I trust these articles because they were written my credible sources, and the information is easy to read and understand. I can then convey this information into a format better suited for my education level, and then make it easier to understand for readers. Article OneThe article, “The Effect of Nurse-to-Patient Ratios on Nurse-sensitive Patient Outcomes in Acute Specialist Units: A Systematic Review and Meta-analysis” is published by Driscoll et al. (2017). In this article, there was a systematic review of the provision of high quality care in acute hospitals. It’s aim was to have an updated review of evidence surrounding nurse staff levels on patient outcomes. It was published to understand the association between nurse staff levels and nurse-sensitive patient outcomes in this setting. The meta-analysis of 175,755 patients, from six different studies, showed a correlation between a higher nurse staffing level and a decreased the risk of in-hospital mortality by 14% (0.86, 95% confidence interval 0.79-0.94) (Driscoll et al., 2017). It concluded that nurse-to-patient ratios influenced patient outcomes and can reduce in- hospital mortality. It was said that additional studies should be conducted to offset the paucity and weakness of the lack of research surrounded this area. We need this information because patient safety is a priority, and we must have adequate staffing to accommodate their needs.Article TwoThe article, “The Relationship Between Understaffing of Nurses and Patient Safety in Hospitals—A Literature Review with Thematic Analysis” is published by Glette et al. (2017). The purpose of this article was to increase knowledge on the understaffing of nurses and any consequence this imposes on patient safety. They concluded that poor staffing increases the risk of mortality, also adverse conditions like pressure ulcers, DVT (deep vein thrombosis), and other related hospital infections. It was also found that understaffing relates to implications pertaining to lack of time nurses could give each patient, lack of quality care, and they faced challenges in safely administering medication. Six of the studies published found a direct link of understaffing affecting patient safety, not caused by direct harm, but increasing their risk for harm later on. Four studies concluded that lack of proper staffing lead to poor quality of care. This includes nursing tasks such as: patient communication, skin/oral care, documentation, and decreased response time to patient alarms and mobilization. 30.39% of nurses reported moderate or poor quality of care, and patient communication was not prioritized in about 39.5% of the shifts. Skin care and back rubs, 24.0%, was frequently reported as undone as well as oral hygiene 19.3% of the time. This impacts patient care and healing time, and also the patients’ ability for self-care and satisfaction was negatively associated with understaffing.Article ThreeThe article, “Healthcare Staff Wellbeing, Burnout, and Patient Safety: A Systematic Review” is published by Hall et al. (2016). The objective of this review was to determine if there was an association between healthcare professionals’ wellbeing and being burned out, in regard to patient safety. It was concluded that poor wellbeing and moderate to high levels of burnout were associated with poor patient safety outcomes, such as medical errors. But due to the lack of prospective studies reduced the ability to determine causality. The article mentions that there is a growing concern in the US over caregiver shortages. This could be due to population increases, increase in chronic diseases, and increased life expectancy. Out of the articles that the study was conducted, over half (59.3%) found that poor wellbeing- depression, anxiety, job stress, mental health issues, distress- was directly associated with poorer patient safety. And the majority of studies found that being burned out, more errors were associated with it (70%). A similar percentage of studies found irrefutable evidence between wellbeing and error (88.9% of studies) as those for burnout and error (83.3%), which indicates the importance of both variables. We need this information to deliver quality care, and the care must be safe. These findings show us that staff wellbeing plays a major role in patient safety. We should take this information and implement a work environment that embodies staff wellbeing and protects them against burnouts.Scope and StandardsThe Nursing Staffing Standards for Hospital Patient Safety and Quality Care Act was proposed to help mandate nurse to patient ratios, this is especially important in acute care settings. It also aims to help empower nurses by obligating registered nurses to act in the best interest of their patients by advocating without regard to bureaucratic and budgetary concern or even the fear of being reprimanded for putting patients first. It also recognizes that nurses are often put in difficult situations where they’re pressured into caring for too many patients. This results in poorer patient care overall. This bill will help remove external pressures and allow nurses and patients to benefit from safe patient care ratios. Lastly, it was signed to dictate that nurses should always put patient safety and well-being above all other concerns, this bill helps ensure this.ReferencesDriscoll, A., Grant, M. J., Carroll, D., Dalton, S., Deaton, C., Jones, I., Lehwaldt, D., McKee, G., Munyombwe, T., & Astin, F. (2018). The effect of nurse-to-patient ratios on nurse-sensitive patient outcomes in acute specialist units: a systematic review and meta-analysis. European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology, 17(1), 6-22.https://doi.org/10.1177/1474515117721561Glette, M. , Aase, K. and Wiig, S. (2017) The relationship between understaffing of nurses and patient safety in hospitals—A literature review with thematic analysis. Open Journal of Nursing, 7, 1387-1429. https://doi.org/10.4236/ojn.2017.712100Hall, L. H., Johnson, J., Watt, I., Tsipa, A., & O’Connor, D. B. (2016). Healthcare staff wellbeing, burnout, and patient safety: A systematic review. PLoS One, 11(7). https://doi.org/10.1371/journal.pone.0159015 Health Science Science Nursing NUR 300 Share QuestionEmailCopy link Comments (0)

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